blogThe Myth of Executive Functioning (EF) Part III: What Does EF Look Like in Youths with ADHD?

As we talked about last time, Executive Functioning, or EF, involves 2 main areas of brain processing:

Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)

Awareness: Awareness of own thoughts and emotions. Also self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the foundation for many other types of executive functions, listed below, all of which assist us achieve goals, act in appropriate ways, and follow through with tasks:

Concentration

Working Memory: holds information long enough to be processed into short term, and then long term memory, for remembering information in the future

Emotion Regulation: Ability to regulate emotions/emotional reactions

Planning

Problem Solving

Time Management

Self-Motivation/Self Initiative

Organization

So, what happens to EF when a youth is experiencing Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD disrupts EF in a variety of ways, and each youth experiencing ADHD will experience EF difficulties specific to him/her (not every person will experience all possible EF difficulties/disruptions).

Listed below are some common disruptions in EF which youths with ADHD experience:

1. Trouble with following more than one direction at a time, and in following through with multi-step directions: For example, when a youth is directed to get dressed, brush hair, and brush teeth, a child sees a book/toy/other item of interest on the way, and then starts reading or playing with toy in the middle of the floor, possibly while only half dressed.

Similarly, when asked to complete chores/responsibilities/tasks, they may need multiple prompts and reminders to stay on task and finish. And, they may leave several tasks partially unfinished.

Or, youths do not understand assignments/test instructions/projects with many steps, and become confused, anxious, and/or frustrated and angry with such tasks.

2. Easily distracted and difficulty remembering information: Due to the inattention and problems with working memory, youths with ADHD may often lose items, even favorite items, as well as forget where they have placed even prized possessions.

Likewise, they have trouble finding papers in their desk, binders, back pack, and folders. They may not be able to find assignments they have completed, or repeatedly forget to turn in an assignment to the teacher.

Additionally, a youth can miss information in a situation, and remember a situation in a way that it did not occur. He/she may then rigidly insist that a situation occurred in a way it did not, or that a person made a certain comment, which was never stated.

Furthermore, youths may miss directions/instructions and, therefore, complete tasks incorrectly, or become confused/stressed/anxious because they do not understand how to complete a task.

3. Poor Awareness/Understanding of Time, and Poor Time Management: Youths with ADHD often have no sense of time. They may overestimate how long a task will take, and, therefore, resist or argue about completing chores, responsibilities, and homework, stating “It will take forever, it will take too long.”

And, conversely, youths with ADHD also underestimate how long tasks will take; as a result, they may not leave enough time to complete projects or tests. Instead of spreading out bigger projects or studying over a length of time, they may wait until a day or two before, and then experience feelings of stress, anxiety, and being overwhelmed, because they do not have enough time to complete the project, or to study.

In addition, youths with ADHD often have difficulty being on time for school or other events, meeting deadlines, completing tests in the required amount of time, and completing tasks in a timely manner.

4. Excessive talking and Frequent Interrupting: Youths with ADHD often talk excessively, due to ADHD preventing the inhibition of responses; they could talk 5-10 minutes without pause, and others are not able to have a chance to talk.

Moreover, they often talk at length about a preferred topic, which may not be of interest to others. This is coupled with frequent interrupting of others, when others try to talk.

Such behaviors are frequently frustrating for peers, friends, and family members. And, due to ADHD interfering with their awareness, they often are not aware/do not realize others are becoming frustrated. Consequently, this leads to problems in making and keeping friends.